Where’s The Honesty When It Comes To Health Insurance Exchanges?

Whether to implement a health insurance exchange remains at the top of state debate as uncertainty over the future of the federal health law continues.

More and more states are choosing to resist implementing a health insurance exchange, at least until after the Supreme Court decision and/or the 2012 presidential election. However, there are those, like Idaho Gov. Butch Otter, who continue to push state-implementation. Gov. Otter has actively supported the use of a $20.4 million federal grant to establish an exchange in Idaho, but, not unlike most health exchange supporters, he has routinely used invalid information to do so.

Beyond his most recently used ridiculous scare tactic regarding Medicaid funding and its “relation” to health exchanges (see here), Gov. Otter, like other insurance exchange proponents, has touted the “state benefits” that come with implementation.

And I, in turn, continue to pull my hair out. Metaphorically speaking of course… but really, enough is enough.

Here’s what we know for certain, and what most states aren’t being told:

1. A “state” exchange simply does not exist.
According to the federal health law, the federal government will have complete authority and oversight of any exchange, and it can completely commandeer any exchange that does not fully meet federal requirements. So, regardless if a state crafts an exchange, it will still not have control over its own health system.

2. That being said, there clearly is no such thing as a state/federal exchange partnership. The federal government remains the authority over state health care.

3. It is a hollow threat that the federal government will take over and implement a health insurance exchange. The federal health law, Section 1311, provides tax credits only to state-crafted exchanges. The law does not provide the federal government funding to establish a federal exchange. Additionally, the federal government does not have the organizational structure or manpower to establish a health insurance exchange.

4. States have only received draft regulations of how to set up a health insurance exchange. Meaning state leaders pushing for implementation of a health insurance exchange or advocating for the use of valuable time and taxpayer dollars to create a system that will require additional time and taxpayer dollars to change, fix, or completely rebuild when final regulations are released.

5. Exchanges will increase health care costs. Upon already high premiums created by the federal health law, state will incur high costs from exchanges, even from just implementation alone. And as premiums rise, it will be state legislators, not the federal government, being held responsible for the extra burden placed on consumers.

6. Establishing a health insurance exchange undermines the 28 state lawsuit pending before the U.S. Supreme Court that challenges the constitutionality of the health care overhaul. A state simply cannot be anti-“Obamacare,” and pro-exchanges. It’s one in the same. And as more exchanges are established, the less likely the Court will want to rule against a system already being put in place.

Yet, despite having this information literally in front of them in the federal health law, legislators like Otter continue to advocate for implementation.

It baffles me, but not quite as much as articles like this one that claim Gov. Otter is taking a “mature path on exchanges,” and a report from the White House claiming states like Idaho are “success stories” the rest of the country can learn from.

I guess I have a different understanding of what constitutes maturity, as it definitely does not include misleading and misrepresenting the needs of constituents.

And the White House’s “success stories?” Well, let’s be honest, this administration’s idea of “success” has been off since the stimulus.

Success in my mind is returning power to patients, and that simply does not start with implementing a health insurance exchange.

— Kendall Antekeier

Kendall Antekeier joined The Heartland Institute in June 2011 as the Legislative Specialist on Health Care. Kendall's responsibilities include interacting with elected officials and staff on health care issues; tracking new legislation; and drafting responses to emerging issues via talking points, news releases, and op-ed pieces, with the goal of educating legislators and informing them about free-market ideas.
Prior to becoming a member of the Heartland staff, Kendall graduated from Saint Mary's College in Notre Dame, Indiana in 2011. There she earned a dual-degree in political science and communication studies, as well as completed scholarly research on the film Frost/Nixon, evaluating its implications regarding the relationship between journalists and politicians. As a student, Kendall worked with the Saint Joseph County Republican Party in South Bend, Indiana, aiding the Party's communication efforts by reporting on both local and national issues and facilitating contact with County candidates. She also held a communication internship position at WZZM 13 News in Grand Rapids, Michigan.